About the opportunity of updated sectorised psychiatry

Abstract

Sectorial organisation of psychiatry and institutional psychotherapy were founded 60 years ago. Sectorial organisation of psychiatry is based on closeness and continuity. It is a matter for a constant presence and availability of health care team, in a centralized place for treatment. This centralized device is especially helped by means of transport. Interlocutor’stability reassure patients suffering of psychics insecurity. We combine to this centralized device with the management of these cognitive remediation therapy measures in groups. This will make metacognitives, neurocognitives and social cognitives functions’s work. We may think and apply these principles with help from institutional psychotherapy paradigm’s and psychanalytic approach of psychosis. So, we help to bring toghether shizophrenic dissociations with the symbolising symbol through a health care team meetings. (cross-sector, dissociated transfert, club function). Sectorial organisation of psychiatry psychosocial reabilitation and cognitive remediation connect themselves in a coherent whole.

The playing area of foundational praxis

Abstract. The institution, in the meaning of the act of instituting, is made possible by the creation of multiple play areas (in oneself, inside the group, inside the society). In the daily clinical work, that introduces a fight against the naturalization of the psychotic processes and the institutional phenomena. To open to the complexity of the human relationships and to the consideration of the weaknesses of institutions and people, to put them into the work, is the stake in the instituent praxis.

Institutional psychotherapy today: a gender policy?

Abstract. The “ambiance”, that Jean OURY held so dear, may no longer exist. We can ask ourselves about the repercussions of scientific and capitalist speeches on the institutional reality of psychiatric care centers. But by asserting certitudes, as either “good practices” or “good economic sense”, are we not preventing thought and debate, meaning that we are reducing politics to an obsolete practice, if not in vain? In our center, association under the French law of 1901, that politics seems to have nurtured since its origin, we want to believe that the disalienation so dear to Marx – as impossible as it may be (as said by Lacan) – must be the goal toward which our practices aim.  As close to the clinical reality of our daily life of psychiatric caregivers as possible, with the risks that psychosis produces, such as isolation, we will present an attempt recently undertaken with our patients, one that is institutional, therapeutic, and political.

Transmission of the psychoanalysis in the psychiatry

Abstract. Psychoanalysis has transmitted to psychiatry a particular idea of the ‘psychic human being’ that has formed the basis of its therapeutic practices even since the domination of ‘biological psychiatry’. In recent years, a new conception of the ‘citizen-patient’ has been challenging the psychoanalytic conception of the mental patient by introducing its own practices and values, supported by a broader movement in society. Nevertheless, the notion of psychotherapy retains its attractive quality as shared psychic work and might enable psychoanalytic thought to maintain its influence in psychiatry.

The decline of psychoanalysis in institutions: homophobia , theoretical dogmatism and therapeutic competition

This text aims to reflect on the origins of the current decline of psychoanalysis in the western institutions and particularly in France. To be more precise, what we have to establish is that the factors which enabled its dissemination are also those which led it to disappear today, namely: the homophobic use of those theories and practices that met hygienist policies in the late XIXth century, and now prejudice it; the lack of an epistemological dimension which was not essential at the time of expansion is now detrimental to its practice in healthcare institutions and in scientific research structures; and finally the absence of theoretical and practical alternative of the early years has given way to an important therapeutic competition with the rise of cognition behavioral therapies. ( CBT)

Dialogue between psychoanalysis and psychiatry

Summary.

This text aims to establish a dialogue between psychoanalysis and psychiatry showing their complementarity, their semantic approach of the symptom and their possible divergence in the outcome of the treatments they provide.

Based on texts by Freud and Lacan, we note that the division of the subject, which is at the origin of its reflexivity, leads the analyst to consider « what speaks » while the psychiatrist will rather wonder about « what we are talking about » as Foucault’s history of the clinic seems to claim.

Psychoanalysis & Psychiatry

The author shows that the debate between psychoanalysis and psychiatry refers to the debate between two incommensurable metaphysical paradigms : on one side, the subject becomes the en-joyment of another meeting, on the other side, the subject comes out of its mother’s womb already reinforced by reason, so that the symptom is at first the effect of the report to the enjoyment when it is for the latter the effect of a brain disorder or a disorder of lear-ning. From this it follows irreconcilable therapeutic practices where it is one side of the fulfilment of a subject and another of its so-cietal adaptation.

The other side of the subject. Psychiatry under question

Abstract
The intention of this paper is to note the contrast between theoretical and clinical psychiatry and psychoanalysis, in which  the psychiatry does not notice the question of the subject and   the psychoanalysis take it seriously this issue. The impact of the discourse of neuroscience in psychiatric discourse has alienated the issue of insanity from the register of truth. By the way.the question of the truth of madness was taken in a crucial way by the psychoanalysis .

Autism: the French historical background behind criticisms against psychiatry and psychoanalysis (I)

Abstract. In France, psychiatry and psychoanalysis are seen as dominant in the support given to austitic persons. There is a gap between the role both plays which is in reality marginal and the dominant representation described by some of its partisans and opponents. Both those disciplines are still seen by parents with the fear of a corporatist influence that can be harmful to their kids’ life and the support they receive. In France, child psychiatry was the instigator of the con-asylum movement between 1955 and 1975. It was then inspired by the “restoration of the subject”, a psychoanalytical ideal. Later on, parents had also to maintain a con-asylum perspective against psychiatry and psychoanalysis. Since 1980, those two disciplines have not always support with discernment the development and the demands of modernisation asked by the family or the society. Those development have widened the useful technical propositions, far beyond the “taking care”, the drug only treatment, and the institutionalsupport ranging from childhood to adulthood, which isfragmented by desertion and rejection by society. For as long as there are discourse from psychiatric and psychoanalytical point of view which purport a so called supremacy concerning the origins of autism or on how to support those individuals, psychiatry and psychoanalysis will provoke hostility.

Read more

Autism: does the imperialism of care exists in the support units ? (II)

Abstract. Since the years 1960, although not represented in support units per se, psychiatry and psychoanalysis have occupied a dominant position in French sanitary and medical-social institutions. In opposition, other disciplines have brought new support modality for autistic persons. Yet, the “everything is therapeutic” era never really existed. This was a fiction that was maintained by psychiatric and psychoanalytical point of view, that didn’t take into account other part of support such as simple childcare in asylum, or, on the other, schooling, or social and educative activity. “Supremacy” of psychiatry and psychoanalysis has declined, but it remains in the vocabulary of many support unit. For family there is a large confusion between “treatment”, “care”, “therapeutic”, “psychotherapy” and “institutional psychotherapy”. The later is not a single approach to analyse actions and interactions in the teams, and forge a constructive criticism which lead to innovation.

Read more